Deborah A Askew
Philip J Schluter
Clare M Maher
Early detection and treatment of diabetic retinopathy (DR) can
prevent nearly all associated severe vision loss. We investigated
the feasibility of DR screening using nonmydriatic cameras in two
Australian primary care clinics.
Two general practitioners from Queensland photographed the
retinas of patients with type 2 diabetes seen in their clinics during
the 9 month study period. The patients were then photographed and
assessed by two independent ophthalmologists. The ophthalmologists’
assessments provided the reference standard. General practitioners’
accuracy in determining photograph interpretability and DR diagnostic
sensitivity and specificity were measured. The attitudes of GPs about
the DR screening were also assessed.
One hundred and fourteen patient participants provided 219
photographs. Two ophthalmologists read 158 photographs and
deemed 61% (97/158) interpretable, but GPs tended to accept
more photographs for interpretation. General practitioners’
diagnostic sensitivity and specificity was 87% and 95% respectively.
Participating GPs were very positive about expanding their clinical
role into DR screening.
General practice based DR screening was feasible and acceptable in
the clinics studied, but photograph quality was an issue.
Type 2 diabetes mellitus (T2DM) is a serious chronic disease worldwide, resulting in significant personal, social and economic costs.1 Approximately 850 000 Australians have T2DM, and based on results from four major Australian epidemiological studies, it is estimated that 25–35% of these have diabetic retinopathy (DR).2 Diabetic retinopathy is the leading cause of preventable blindness in adults.3 Early detection and appropriate treatment can prevent nearly all severe vision loss and blindness from DR.4
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